FORT LAUDERDALE, Fla. – Prescription drug prices are skyrocketing in Florida.
Name brand medications used to treat cancer, diabetes, asthma and other conditions have increased as much as 73 percent since 2015.
Drug pricing experts reveal a key factor in that shift and the impact it’s having on people in need of vital medications.
As executive director of the National Multiple Sclerosis Foundation, Natalie Blake has seen patients face the high cost of dealing with the disease.
“The average cost of the disease modifying drugs for M.S. cost about $60,000 a year,” Blake said.
Antonia Ciaccia, a drug pricing expert, said the rise in prices of all kinds of medications has been due, in part, to the business practices of pharmacy benefit managers, or P.B.M.’s.
“Pharmacy benefit managers were architected decades ago as a means to do the simple act of facilitating the claims transaction at the pharmacy counter on behalf of the patient with their insurance company,” Ciaccia said.
Originally intended to control drug costs and accessibility, pricing experts said these middlemen between drug manufacturers and insurance companies are now driving up the cost of prescription drugs.
“P.B.M.’s started to get paid by drug manufactures. P.B.M.’s started opening their own pharmacies, so rather than just working to control the price of the transactions, they began profiting from the transaction,” Ciaccia said.
According to data acquired by the MS Foundation, three P.B.M.’s control at least 80 percent of the drug transactions in the U.S.
And while these P.B.M.’s negotiated an estimated $82 billion in rebates from drug companies, transparency laws in Texas showed that just two percent of those rebates were passed onto consumer in the form of lower prices.
Blake, who suffers from asthma, said P.B.M.’s also control access to medications.
“I was on a drug for five years and I get to the pharmacy and they say it’s not authorized,” she said.
Now a push is on to change how P.B.M.’s operate.
“We need to recalibrate their incentives so they no longer profit off the rising prices of pharmaceuticals, but instead profit when they successfully lower the cost of that medication and pass those savings on to consumers,” Ciaccia said.
The MS Foundation and other groups have called on the Federal Trade Commission to investigate the impact B.P.M.’s have on millions of Americans.
Their intent is to improve patient access and affordability to necessary medications.